Nuclear Techniques Before and After Coronary Revascularization

In order to improve the clinical outcome of patients with cardiovascular disease, appropriate therapeutic options should be selected including medical treatment and coronary intervention. Current available data indicates that revascularization should be the treatment of choice in patients with moderate-to-severe inducible ischemia and/or abnormal myocardial blood flow in the matching territory, measured by radionuclide techniques. Conversely, invasive procedures – and associated costs and morbidity – can be safely avoided in patients with no significant ischemic burden. Refined targeting of the areas to be revascularized using quantitative blood flow measurements with PET may further improve the outcome of patients submitted for intervention. Following revascularization, perfusion studies provide crucial diagnostic and prognostic information, and their use is appropriate during follow-up in those individuals with recurrent symptoms. However, routine imaging in asymptomatic patients is still controversial and mostly reserved for high-risk populations, despite an increasing trend for testing all patients during long-term follow-up after intervention.